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Influence of travel burden on tumor classification and survival of head and neck cancer patients

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Abstract

Purpose

Cancer patients have to overcome various barriers to obtain diagnostics and treatment at head and neck cancer centers. Travel distance to a specialized hospital may result in psychosocial and financial distress, thus interfering with diagnostics, treatment, and follow-up care. In this study, we have aimed to analyze the association of travel distance with cTNM status, UICC stage at primary diagnosis, and survival outcomes of head and neck cancer (HNC) patients.

Methods

We have analyzed data of 1921 consecutive HNC patients diagnosed between 2014 and 2019 at the head and neck cancer center of the Comprehensive Cancer Center Ulm (CCCU), Germany. Postal code-based travel distance calculation in kilometers, TNM status, and UICC stage were recorded at initial diagnosis. The assembly of travel distance-related groups (short, intermediate, long-distance) has been investigated. Moreover, group-related survival and recurrence analysis have been performed.

Results

In contrast to observations from overseas, no association of travel distance and higher cTNM status or UICC stage at primary diagnosis has been observed. Furthermore, no significant differences for recurrence-free survival and overall survival by travel distance were detected.

Conclusion

In southern Germany, travel distance to head and neck cancer centers seems to be tolerable. Travel burden is not synonymous with travel distance alone but also involves sociodemographic, monetary, and disease-specific aspects as well as accessibility to proper infrastructure of transport and health care system.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author information

Authors and Affiliations

  1. Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, Frauensteige 12, 89075, Ulm, Germany

    J. M. Vahl, A. von Witzleben, J. Doescher, M. N. Theodoraki, M. Brand, P. J. Schuler, J. Greve, T. K. Hoffmann & S. Laban

  2. Clinical Cancer Registry Comprehensive Cancer Center Ulm, Ulm University Medical Center, 89081, Ulm, Germany

    C. Welke

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  1. J. M. Vahl
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Correspondence to J. M. Vahl.

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Conflict of interest

Simon Laban: Advisory Boards: Merck Sharp & Dohme (MSD), Bristol Myers Squibb (BMS), Astra Zeneca (AZ), Sanofi Genzyme. Honoraria: MSD, BMS, AZ, Merck Serono. Patrick Schuler: Advisory Boards: BMS, MSD. Thomas K. Hoffmann: Advisory Boards: MSD, BMS. Honoraria: MSD, BMS, Merck Serono. All other authors declared no conflict of interests, which could have influenced this work.

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Vahl, J.M., von Witzleben, A., Welke, C. et al. Influence of travel burden on tumor classification and survival of head and neck cancer patients. Eur Arch Otorhinolaryngol 278, 4535–4543 (2021). https://doi.org/10.1007/s00405-021-06816-3

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  • DOI: https://doi.org/10.1007/s00405-021-06816-3

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